HomeMy WebLinkAbout02-0743
PETITION FOR PROBATE and GRANT OF LETTERS
) Ivo. 21 ~ oz-1N3
also known as ~~, y,~, - G?~is~+ } TO:
Deceased. 1 Register of Wills for the County
Socia/ Security No. 076 22 2373 } of Cumberland in the Commonwealth
} of Pennsylvania.
The petition of the undersigned respectfully represents that:
Your Petitioner is 18 years of age or older and the executor named in the last will of the above
decedent, dated 9 February 2001 and codicils} dated nn/a.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or
principal residence at 824 Lisburn Road, Camp Hill, Pennsylvania.
Decedent, then 74 years of age, died on 12 July 2002, at 824 Lisburn Road, Lower Allen
Townshit~ Cumberland County. Pennsylvania.
Except as follows, decedent did not marry, was not divorced and did not have a child born or
adopted after execution of the will offered for probate; was not the victim of a killing and was never
adjudicated incompetent: n/a
Decedent at death owned property with estimated values as follows:
(if domiciled in Pa.) All personal property
(if not domiciled in Pa.) All personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
Situated as follows: n/a
S 100,000.00
S
S
WHEREFORE, Petitioner(s) respectfully request the probate of the last will and codicil(s)
presented herewith and the grant of letters (testamentary, administration c.t.a.; or administration
d.b.n.c.t.a.-
Signature and residences of ~etitioncr(s1:
Donald B. Cornish, Jr.
103 Linden Drive
Camp Hill, PA 1701 1
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ) SS.
COUNTY OF )
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition
are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal
representative(s) of the above decedent petitionerls) will well and truly administer the estate according
to law.
Sworn to or affirmed and subscribed
before me this 14th day or`
AUGUST 2 0 2 .
~ ~:~~
Q. Register
1
Donald B. Cornish, Jr.
103 Linden Drive
Camp Hill, PA 1701 1
l-7-A~ - I~
Estate of `~i~~,- ~~ .,c ~~d~~~ ,Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW AUGUST 16. 2002 19 , in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated 9 ~y~~. ~~)
described therein be admitted to probate and filed of record as the last will of ~c~
asd Letters '~ -~r.~„-,~_'~~~.,r ------.._.~_._._
are hereby granted to
FEES
Probate, Letters, Etc. ......... ~ ~~~ 00
Short Certificates( ) .......... S 18.00
.xt~a.pages... ~ i~ n0
jcp ~ 5.00
TOTAL ~ 270.00
Filed 8-16-2002
..........
tnailecl ~to atty 8-16-2002
1 '~
R ster of~~'•tlls
~~~ ~e~ L. f -~.~~e5
ATTORNEY (Sup. Ct. LD. No.) l'~ZZS
~ ~ (~ ~~, ~ ~ ~a
ADDRESS ~ J'j~3
(T ~ ~6 ~ ~ ~3b1
PHONE
t
,e
1 u1 ~.81R Kra' J/N(,
~~-~tis is ro certi.f-~~ teat the information here given is correctly copied from an original certificate of death duly filed with me as
LL)cal Registrar. 7~he original certificate will 6e Forwarded ro the Stare Vital Rec:~ords Office for permanent filing.
WARNING: It is iffegal to duplicate this copy ny photostat or photograph.
E ec for this certificate, ~~'.00
No.
r
F' r ;
Local Registrar ~ `~~
(j`
~u~ ~ z X002
Date
aJ Hey 2x01 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
_.v._._° ~_..___-a~~-~.. ____-_ ~___
NAME OF DECEDENT (Fee MgWe, Taal __~~._. _
SE% $r,iC1Al SECURITY NUMBER
DALE OF OEATH,MCrun. Day, rear) I
+. Margaret West Cornish :.female ~. 076 - 22 - 2373 .. July 12,2002
AGE Ilan Bvtnday) UNDER 1 YEAR UNDER 1 DAY DATE OF 81flT14 BIRTHPIACF IC•ry arA PLACE OF UEATN Iflna:x rvay ENV: :I..v~v ur user 7x101
-_-~
.~ r'x _ __
MoNna r Days Ibwa . Minulsa ,,aunm UaY 1 3ulea.creyn l:una'y)
a HOSPITAL.--- OTHER:
ovember
5 , Brooklyn
NY Inparrant ^ ER/Oulpalr.N .-~
DDA G "Ha,'"'"'°. ^ Rarbnca i
'l ;(S~aYI ^
74 Yra.
,. _ ,
e,_ 19 2 7 ~ w. _ _
_
COUNTY OF DEAR CITY, BORO. 7YVP OF DEATH FACILITY NAME In ,wl x,vruuw~. y ve meel aw nwnpxi WAS DECEDENT OF HISPANIC ORIGIN) RACE -Amarrcan InWan, BMta, Wnaa. Ne.
lao ~ Ya l~ M yea. aPacey Cuban. 1SS+erhl
Cumberland Lower Allen Tw
p • 824 Lisburn Road M.alon,PwrlaRean,«c white
w. k. w. _ ,. ,,.
DECEDENT'S USUAL OCCUPATION KIND OF BUSINESYINDU57flY WAS DECEDENT EVERIN DECEDENi'$E(NICAT KNI MMITAL STATUS~Marrad
i SURVIVING SPOUSE
(Cave kaa d w«M done drnury rrga U S. APMED FORCE S? ISpeulY orav nu ea. aJe cm~jaal W NevN M>rnad. W
dowed,
S al wee. gve nwden narnel
dwdaigMa:mrrdusereNOd) Rtl
^ ElNrwnlary/Sacwaary Cwle9a DrvacW(
pecNl
- ,,.Dental Assistant ,,,. Dentistry ,_ Ya
"° ,o alz) 2 11+ws.l ,a Widowed ,,.
DECEDENT'S MAILING ADDRE SS ISIreN. CeY/TO'-n. SM1a,LV COda1 DECEDENT'S p
Lower Allen
i
l
~1
van
a ,7~.
ennsy
yn.. d.~.d.N a..dn
ACIUAL Ile. SIMe Did 1•~P
824 Lisburn Road RESIDENCE acwNa
Camp Hill
PA 17011 ISee narucraru ava n a
w,uner,a•l Cumberland '°'•"'"'p?
~
i
~
^
,
,w ,1d.
w
i
w,bn
a,d _ _
11e. co~my--------- -- - - ----caYAeae
F/DHER'S NAME (W a. Maas. Laa) MOTHER'S NAME IFva. Mxk11e. MaaNl Swnane)
,,, Frederick Power West ,,. Julia Cave
INFORMANT'S NAME C1 ype~Prad) INFORMANT'S MAKING ADDRESS 4SneM, Cay/Town, SWIe. LW Coda)
„a. Donald B. Cornish, Jr. ~, 103 Linden Drive, Camp Hill, PA 17011
METHOD OF DISPOSITION DATE Of DISPOSITION PIACE OF DISPOSITION - Name W CamNary, Cromauxy LOCATION ~ Ciry/Town, Sula. Lp Cou
Brrrlal ^ Cramalron ~ Removal Mom SIaU ^ (Main. (yY, A,al d O1Mr PMca
^
Dorlalm^ OIMrISDacMI Yorktowne Cremation Servi e York, PA 17404
xt ]Ib. ' ~~~~ 11 c. 7,d.
SIGNATURE FUN S V E oR PERSON ACTING A$SUCN LICENSE NUMBER NAME AND AODHESS OF FACILITY parthemore FH & CS, Inc.
3zb, FD 013 340 L ::<P•0. Sox 431 New Cumberland, PA 17070-0431
Comp,ata aama corny wean unlryr b dr DaN W my krowlatlya, d,an occuueo dl Ina nme, tlale >nd pace SI>Iad LICENSE NUMBER DATE SIGNED
p0yairaan a nd iaaiM04 a11aM of dawn 10 (Sq,alwe aixl' I dle) IMOraR Day Yearl
candy cauaa of haN.
zaa. Jam. _ Jx.
,a,ns Ya-26 mua l»compdatlW TIME OF DEATH DATE PRONOUNCED DEAD(MW,m. Day. Year) WAS CASE REFERRED IU MEd E7j~y1NER/CORONER)
• Parton wM prwgwKN deaN. r / Fb ^
ZT. PA/1T l: En4r IM dsaasas. mryras a compxcanora wnrch caused Ilw dram Do ml anger Ine mou W dying, sw:n as cardac ar respnalory anesl, snw:E or neap laaura r Aiproumaa PART 11: OUIa sgndkaM rprwaiens oaNriE Wig to OsaN. lwt
lua only ou cause on eacn nna ~ auwal oalwaan nd rasWlag n IM wldanyvgcauaa W+•n n PAAT 1.
`~ r r omN and dwln
WME0111TE CAUSE
F
/
'
vw r
I
~ C1 I
(~ ` ,y~
~ •Y \~~1~4.{111 L~ ~~1~1~.1~~,1~\~~ ~
/a ~~ Ga~~•-. a
--
.
_ _._ _r-
Ol1E TOIOR AS A CCt15E0UENCE OFr -
Sarllraralaey lit ca,diona b. _.-_____ _._.~_
Zany, laadigwamadau DUE 70lLNi AS ACOIa5E0UENCf DF). ,
aaw ENar UILDERLYBaO 1
CAUSE tD Sraa.n~nwy c.
r
• autvWaed avarKS _~__ ~
-
Dl1E W(OR ASACDNSEOUENCE OF).
raauMg n dean) IAST I
r
• d. ___.~____..___ ___
Nils AN AUTOPSY ViERE AUTOPSY FINDINGS MANNER OF UEATN PATE (7F INJURY 7 WE [N~ INJURY IN.IURY qT WORK7 DESCRIBE HOW INJURY OCCURRED.
PETKORMED7 AWILABLE PR10FLt0 IMaam,. Dav. vna.l
COMPLETION a CAUSE
l
N
l
~
H
U
OF DEAR) a
wa
om~cga ~ ^ ~ ^
(
~
)
AtCdaN
L
J Pending lnMNgala)n ~J
YM ^ No~ Yea ^ No ^ ))
T
~
Surcrds ^ (iOUW rlol Oe delNminad ~-.i ~~__ -. _ ~~.._.____ M~ 70c.
PLACE OF IFUURY ~ AI nonw. Iar , WeN. Nclory, olllca LOCATION iSbeN. GIYliuwn. Sl'alel
lxnldmg, Nc. ISPec~IV)
JM. I,C. 29. J0.. 701.
CERTIFIER ICnec> wny noel
'CENTIFY,/G PHYSICIAN IPnysic.an cerWyntl tansadrfeaur.Me~ anwner ynvvr:~an lwsgaxnnu.eo neam ano ~pnylelcrl Hero 2Jl SIGNATUR T TLE OF ER7 IE r
~ - !'
~G }"1~
~
To 111a OaU o1 my knowNdga, daatn occurred dw b me cauaalsl and manrvr sa elated .......... . .......................................... C~ ~,`~
~ t.
7ta.
__~_
LICENSE NUMBER --, DATE SIGNEDIMwan. Day. Vaarl
'PRONOUNCING AND CERTIFYING PHYSICIAN IP+rYSx:wn Ir,u: „onu„r~c~ny uedm era cermylnq ro ~,ause W oeaml
V
~
To Ilia D
e, of m
an
wl
w
1A
uvr
d
d
d
l th
W
t
O
d
l
d ~;L~) / `
~" U ~
I ~ 71 d
JiC
~
~
_
y
g
,
e
o
a
ea
xc
a
a
e
ne,
a
s, an
p
ace, an
dw to Iha cauaelal and manner as elated .......................... . _ _
.
_
_
_
ET CAUSE
F
DEATH
NAME AND ADDRESS OF'PERSON WNO C~1
l
O
.~
MEDICAL EXAMINER/CORONER
. ~
}
-
(Item Ill Type ar Pnnl ~ )~ ~_ T.. -4 `
~`
~[
I
~.~t-~
On IAe baNa of uaminalion andl0r innesti atwn, m .,, dea1/1 occurred al Ine lime, dale, and race, and due to the cause e) srW
. Y opimo4
P
~
manmr ae aUtad .....................9
.
.
.
~
~ 2
`- ~~
_
.
.
..
......................
....................
.....
.._..,....
],e C
J2.
~ ~~ l~~l ~~ 1 t
~.
REGIS;j1,t,R'S SIGNATURE AND NUI.yaEf;J ___
.
DATE FILED IMwnr Day. Yeas 1
I, MARGARET E
WILL
OF
MARGARET E. CORNISH
CORNISH, of Lower Allen Township, Cumberland County,
Pennsylvania, declare this to be my fast will and revoke any will previously made by me.
ITEM I. I direct that all my just debts and funeral expenses, including my
gravemarker and all expenses of my {ast illness, and any and all taxes and assessments
imposed by any governmental body as a result of my death, whether on property passing
under this will or otherwise, shall be paid from my residuary estate as soon as practicable
after my decease as a part of the expense of the administration of my estate.
ITEM II. I give, devise, and bequeath all of my possessions and estate of every
nature and wherever situate to my husband, DONALD B. CORNISH, provided he survives
my death by sixty (60) days. Should my said husband predecease me or be deceased on
the sixty-first day after my death, 1 give, devise, and bequeath all of my possessions and
estate of every nature and wherever situate, as follows:
A. The sum of Thirty Thousand (530,000.001 Dollars to my husband's
son, DONALD B. CORNISH, JR., provided he survive my death by sixty (60)
days.
B. The sum of Thirteen Thousand Five Hundred (513,500.00) Dollars
to my daughter, JOANNE T. WENGER, provided she survive my death by sixty
(60) days.
C. The sum of Thirteen Thousand Five Hundred (513,500.00) Dollars
to my daughter, SONDRA LEE HAMMOND, provided she survive my death by
sixty (60) days.
D. The sum of Two Thousand (52,000.00) Dollars to my husband's
granddaughter, ARA GUILLE, provided she survive my death by sixty (60)
days.
Page 1 of 5
E. The sum of Two Thousand (52,000.00) Dollars to my husband's
grandson, ZACHARY HOLMES, provided he survive my death by sixty (60)
days.
F. The sum of Two Thousand (52,000.00) Dollars to my grandson,
WILLIAM RICHARDS, JR., provided he survive my death by sixty (60) days.
G. The rest, residue, and remainder of my estate and possessions of
`\
~?
every nature and wherever situate I leave as follows:
(1) One-half thereof to my husband's son, DONALD B.
CORNISH, JR., provided he survives my death by sixty (60) days;
(2) One-fourth thereof to my daughter, JOANNE T.
WENGER, provided she survives my death by sixty (60) days;
i
F
J
~v
(3) One-fourth thereof to my daughter, SONDRA LEE
HAMMON, provided she survives my death by sixty (60) days.
In the event that any of the persons entitled to a share under this sub-
paragraph predecease me or fail to survive my death by sixty (60) days, I
direct that their share shall pass to such of their issue, per stirpes, as survive
my death and in the event that they leave no such issue, then to the other
persons taking under this sub-paragraph of this my last will.
ITEM III. I appoint my husband, DONALD B. CORNISH, executor of this my last
will. Should my said husband predecease me or otherwise fail to qualify or cease to serve
as executor of this my last will, I appoint my husband's son, DONALD B. CORNISH, JR.,
executor of this my last will.
ITEM IV. All of the interests of the beneficiaries hereunder shall not be subject to
anticipation or to voluntary or involuntary alienation nor shall they be subject to any
execution or attachment.
ITEM V. In addition to the other powers and authorities granted to my personal
representative by Pennsylvania Law and by the other terms and provisions of this will, I
hereby give to my personal representative the following powers and authorities effective
Page 2 of 5
without court approval and until actual distribution of all property: to compromise any claim
or controversy; to make distribution in cash or in kind, or partly in cash and partly in kind,
and in such manner as my personal representative may determine and at valuations finally
to be fixed by them; to invest in all forms of property, including any stock or other
securities in any corporate fiduciary or its successor without restriction to investments
authorized for Pennsylvania fiduciaries, as my personal representative deems proper,
without regard to any principle of risk or diversification; to retain any or all assets of my
estate, real or personal, without regard to any principle of risk or diversification; to sell at
public or private sale, to exchange, or to lease for any period of time, any real or personal
property and to give options for sales, exchanges, or leases, for such prices and upon such
terms or conditions as my personal representative deems proper; and to allocate receipts
and expenses to principal or income or partly to each as my personal representatives deem
proper in their sole discretion.
ITEM VI. I direct that my personal representatives and fiduciaries shall not be
required to give bond for the faithful performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand this ~/ day of
--~-~,, , 2001.
~ ~,'
MARG T E. CORNISH
Page 3 of 5
The preceding instrument, consisting of this and three other typewritten pages, each
_`
v
---__
d~~
i
a
~~
identified by the signature of the testatrix was on the date thereof signed, published, and
declared by MARGARET E. CORNISH, the testatrix therein named, as and for her last will,
in the presence of us, who at her request, in his presence, and in the presence of each
other, have subscribed our names as witnesses hereto.
u I L. Andes
Amy Har ~ s
Page 4 of 5
COMMONWEALTH OF PENNSYLVANIA 1
1 SS.:
COUNTY OF CUMBERLAND 1
The undersigned, being the testatrix whose name is signed to the attached or foregoing
instrument, having been duly qualified according to law, does hereby acknowledge that l signed and
executed the foregoing instrument as my last will, that I signed it willingly; and that I signed it as
my free and voluntary act for the purposes therein expressed.
MARGA E E. CORNISH
Sworn or' affirmed to and acknowledged
hefore me by the testatrix named above
this `j ~ day of fed /'urxn 7 2001.
~~ ~ NOiARIA1 SEAL
EHRENFEID, NOTARY PUBLIC
i~lotary ublic LEMOYNE BORO., CUMBERLAND CO.
MY COMMISSION EXPIRES AUG. 17. 2ona
COMMONWEALTH OF PENNSYLVANIA
( SS.:
COUNTY OF CUMBERLAND 1
WE, SAMUEL L. ANDES and AMY HARKINS, the witnesses whose names are signed to the
attached or foregoing instrument, being duly qualified according to law, do depose and say that we
were present and saw the testatrix sign and execute the instrument as her last will; that she signed
it willingly and that she executed it as her free and voluntary act for the purposes therein
expressed; that each of us in the hearing and sight of the testatrix signed the will as witnesses; and
that to the best of our knowledge, the testator was at that time I$ or more years of age, of sound
mind, and under no constraint or undue influence.
Sworn or affirmed to and
ackno~lvledged before me this
~ ~` day of Fe d r~~y , 2001.
L. Andes
Amy Hark s
L
Notary ub!ic NUTARfAI SEAL
LYNN E}iRENFELD, NOTARY PUBLIC
LEMOYNE BORO., CUMBERLAND CO.
MY COMMISSION EXPIRES AUG. 11, 2004
Page 5 of 5
R;V.'>OOox ISJ..',;
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I-
Z
W
o
w
()
w
o
DECEDENT'S N.4.ME (LAST, FIRST, AND MIDDLE INITIAL)
Cornish, Margaret E.
DATE OF DE.-'TH (MM.DD.YEARj
07-12-2002
DATE OF BIRTH (MM-DO-YEAR)
11-05-1927
/
<;!~~\
__.-lJ_______~'*__JQ _
FiLE NUMBER.
21_020743
eout:"iY CODE 'f~
-----
NUW.eER
I SOCIAL SECURITY NUMBER
! 076 - 22
2373
(IF APPLICABLE) SURVIVlNG SPOUSE'S N~ME {LAST, FIRST, AND MiDDLE lN1T1AL)
None
w
>-
lI::;:Ul
u"'"
w~"
,,00
",,~
~'"
~
<
[KJ 1. Original Relurn
04.UmiledEstale
06. Decedent Died Testate tAttach::OPl'Oflt.'il!)
D9.LiligaiionPro~sReceiYed
o 2. Supplemenlal Return
o 4a. Future Interesl Compromise (.:late cftlealhaller12-12.li2j
o 7. Decedent MaintaineO eo Uving Trust !1i.l:8c.'> etlpyol1rust)
o 10. Spousal Poverty Credit (date of dooll1 bIl1Wcer, 12.a1-91 and 1.1.95)
o 3. Remain~r Re1um (date cfdeathprXlrlQ 12.13-S2)
o 5. Federal Estate Tax Return Required
8.latal Numoor of Sale Deposil Boxes
011. E!ecnonto tax under Sec. 9113(A) {Albdl &h 0\
~
z
w
c
z
o
~
'"
w
"
"
o
"
BJ;S.llDl!l[il'NPEIlIi!llil; Il!_
COMPLSE MAILING ADDRESS
, c i1iI()lIi]SJ:1.0J1UD;BE;oIRECiI'ED~TO'"
';ffiHI_Sill!;9'tltlNfMl:! ' , Si'(:pMfi' )
NAME
Samuel L. Andes
FIR,.,," NAME (If Aoplicltllej
TELEPHONE NUMBER
(717)
761-5361
\ TI.nS R.ETURN MUST BE ALED IN DUPL.ICATE WITH THE
REGISTER OF WILLS
SOCiAL SECURrTY NUMBER
525 North 12th Street
Lemoyne, PA 17043
(1)
(2)
(3)
(4)
(5) 231,853.86
(6) 8,713,54
(7) 41,706.84
(9) 9,133_35
(10)
i2. Net Value of Estate (line B minus Line 11)
13. Charitable and Governmental BequeslsiSec 9113 Trusts fer whic."', an alectbl', to tal: has rIOt De$',
made (Schedule J)
14. Net Value Subject to Tax (Una 12 minus Une ia)
OFFICIAL USE ONLY
(8) 282,274.24
(11) 9,133.35
(12) 273.140_89
(13)
(14} 273,140.89
x.O_ (15)
x,O_ (16) 12,291.34
x .12 (17)
x.15 (18)
(19) 12,291.34
2Q_O
- ",',' , " - -;"(T- '" ;at'S">eE SURE,TOYjllSWER_;ACL 'Qt:lES'!'lclN_S'ON:R6IIERSEisI!lEi<\NO 'I%CHECi<-MATH,~ ~,'
1. Real Estate (SChedule A)
z
o
5
;:)
l-
ii:
<(
()
w
a::
2. Stocks and Bon<J:s {Schedule Bj
3, Closely Held Corporation, Partnarship or Sole-Proprietorship
4. Mortgages &, Noles Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
{Schedule E)
6. Jointly Owned Property (Schedule Fl
o Separate Billing Requested
7, Inter-Vivos Tlsr:Sfers & Miscellaneous Non.Probate Property
(Schedule GorL.]
15. Amount of Une 14 !exable althe spousal tar.
rate, Q"transfers under Sec. 9116(01)(1.2)
SEe INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
z
o
1=
~
::l
c..
:;;
o
()
><
~
19. Tax Due
CHECK HERE {F YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
R Total Gross Assets (Iota! Lines 1.7)
9. Funeral Expenses & Administrative. CQSts {Schedule H)
iv. Debts of Decedent, Mortgage Liabilities, & Llans (Sche<lule I)
11. Total Deductions (lalal Lines 9 & 10)
16, AmounlafLine14taxableailinealrale
273,140.89
17. Amount of Line 14 taxabJe atsibting rate
18. Amcunl af Line 14 taxable at ooilateral rale
Decedent's Complete Address:
STREET ADDRESS 824 Lisburn Road, Apt. 222
-.----
CITY
Camp Hill
1 STATE PA
I liP 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Une 19)
2. CreditslPayments
A. Spousal Poverty Credit
B. Prior Pa'jments
C, DIscount
(1) 12,291.34
Total Cred"s (A+ 8 + C)
(2)
0.00
3.
InteresVPenalty if applicable
D.lnterest
E. Penally
4.
Total Interest/Penalty ( D -I- E )
\f Line 2 "IS grealer than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
0.00
5.
If Line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE.
(3)
(4)
(5)
(SA)
12,291.34
A. Enter the interest on the lax due.
8. Enler Ihe tot,1 of Line 5 + 5A. This is the 8ALANCE DUE. (58) 12,291.34
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Yes
m.m.O
o
.......0
mO
..........~
o
...0 0
IF THE ANSWER TO ANY Of THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
1. Did decedent make a transfer and:
a retain the use or incoma of the property transferred;.............".....
b. retain the right to designate who shall usa the property transferred or its income;
c. retain a reversionary interest; or.."........................."........................
d. receive the promise for life of either payments, benefits or care? ".". ...... ........"..
2. If death occurred atter December 12, 1982, did decedent transfer property within one year of dea\h
without receJving adequate consideratron? ........,,,,,..... . ....................... ........ ,..........
3. Did decedent own an "in trust for" or payable upon death bank acoount or security at his or her dea\l'l?...
4. Did decedent own an Individual Retirement Account, annuity, or other non~probate property which
contains a beneficiary designation? ......"..."........"................... ........"....."...... ............. ".......
No
ijIJ
~
12:1
o
~
Under penallies of perjury, I declare Ihal! have examined U1is ttllum. inctuding acc:ompany!ng schedules and slalarnenis, and to the best of my know~ge and belief. il is true. correclend
rornpiete.
DedaratiOllcfpreparerclherthanlhepersooalflJpresenlatlvd i$based on all informalion 01 whichpreparethasar,ykncwledge.
SP
7'tM-1'/':tJ-v L/- l-tJ1 V
ADDRESS
525
For dates of death on or atler July 1, 1994 and be10re January 1. 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. 19116 (0) (1.1) (i!].
For dates af death on or after January 1, Hill5, 1he tax rate imposed on the net value of transfers to or for the usa of the surviving spouse is 0% [72 P.S. 99116 {a) (1.1) (iilJ-
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are stili applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The lax rate imposed 0'1 the net value O{ transfers flOm a deceased ct1i1d twenty-one years of age or ;'{lungeI' at death to or lor the use of a natural parent. an adoptive parent,
or a stepparent of tlle child is 0% [72 P.S, g9116(a}(1.2)].
The tax rate imposed on the oot lialue cftransfers to or for the use 01 Ihe decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. S9116{1.2) [72 P.S. 99116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P,S, s9116(a)(1.3)j. A sibling is defined. under Section 9102, as an
individual who has at ieast one parent in common wilh the decedent, whether by blood or adoption.
RP/.\!,>:.;:(J>n..n
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
21-02-0743
COMMON",\lEAL TH or PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT [CEDENT
FILE NUMBER
lnclu<te the proceeds of litigation and the date the proceeds were received by the estate. All property iointly.owned with th6 rigl\t o-f 'OUN\~OfSh\p must bt disclosed on Schedule F.
Cornish, Margaret E.
ITEM
NUMBER
1.
DESCRIPTION
Certificate of Deposit No. 31900129083 at PNC Bank. Date of Death
value, including interest (see attached report from PNC Bank).
2.
Certificate of Deposit No. 247412043558826 with First
Union/Wachovia Bank. Date of death value, with interest (see letter) .
VALUE AT DATE
OF DEATH
$25,021.92
$10,011.13
$10,007.19
$10,021.48
$65,107.61
$1.00
$1,179.78
$3,500.84
$1,000.72
$1,000.72
$11,522.08
$21,322.53
$17,024.65
$10,013.71
$30,033.53
$500.00
$14,584.97
3.
Certificate of Deposit No. 247412043559461 with First
Union/Wachovia Bank. Date of death value, with interest (see letter).
4.
Certificate of Deposit No. 247412050824442 with First
Union/Wachovia Bank. Date of death value, with interest (see letter).
5.
Certificate of Deposit No. 247412050843729 with First
Union/Wachovia Bank. Date of death value, with interest (see letter).
6.
Checking account No. 1014214321722 with First Union/Wachovia
Bank. Date of death value (see letter attached).
7.
Share savings account No. 1094-00 with Susquehanna Valley Federal
Credit Union. Date of death value including interest (see letter).
8.
Certificates of Deposit with Susquehanna Valley Federal Credit Union.
Date of death values including interest (see letter).
No. 51-4224
No. 51-4239
No. 51-9465
No. 53-3962
No. 53-4050
No. 53-4238
No. 53-4399
No. 53-4382
9.
Miscellaneous items of clothing, jewelry, one or two pieces of furniture,
and other tangible personal property.
10.
Checking account No. 5140013287 with PNC Bank
TOTAL (Also enler on line 5. Recapitulation) $ 231.853.86
(If more space is needed, insert additional sheets of the same size)
,
PNC Bart., N:,..
4242 Carlisle Pike
Camp HiIl,PA 17011
Estate of Margaret E Cornish (Deceased)
SS# 076-22-2373
DOD 07-12-2002
PNCnm.NK .
~
ACCOUNT NUMBER "DATE OF DEATH BALANCE + ACCRUED INTEREST
'CDS #21001028202
CDS #21001028248
- CDS #21001028203.
CDS #21001028247
- CDS #21001028249
- C.IlS 1tslq~o(';''i'''83
nn~ ...". A"01328~
t _ .--- -_.-, rrv I"'TU I
QftJ1 de : 'j
$3,000.00
$5,000.00
$3,000.00
$5,000.00
$4,043.39
t~S; ooo.G'O
$14,583.06
+
+
+
+
+
...
$8.85
$14.39
$8.85
$14.39
$11.64
".;11. ct~
$1.91
tJ /.1 /7
7 - UI - lP
+
Page: 1 Document Name: untitled
CIl5 2 IDS
CDA/REA CUSTOMER INQUIRY 09/12/02 13.02.30
MS ACTION SUCCESSFUL
PROD> CDA BRANCH 00114 COST CENTER 0000114
SUBPRDCT MT FIXED RATE
SUBOWNER 01 REGULAR
BANK
40
~
CUSTOMER NUMBER 2001000638
NAME GAINOR SAN~RA f) J
tMtHraa(QT f,'L M'NiS",
NAME SAND~GAINOR
& 1434 GREEN ST
ADDR HARRISBURG
ACCT>
PA 17102-2644
RELATIONSHIP
TIN 194-44-9610
WTHLD CD PC CERTIFIED TIN
DATE WTHLD CERT 08/28/2002
BIRTH DATE 07/07/1951
LAST MAINT DATE 09/05/2002
REA PLAN
PACKAGE CD
ADDED 05/12/1999
REMOVED 09/05/2002
COUNTRY
SEL SUB ACCOUNT RST
MTfl~~
ISS/RENEW MATURES PKG
04/25/2000 04/25/2005 HD
Lj -.).~-'lS"
APY
5.66
CURRENT BALANCE
0.00
STAT
07
TOTAL
1
0.00
PF: I-HELP 2-MSGS 3-PLVL 4-RRS 6-CIF 7-S8 8-SF 9-CI34 10-CI10 11-Cl11 12-CI50
Date: 9/12/2002 Time: 1:05:53 PM
Page: 1 Document Name: untitled
Cll5 2 IDS
CDA/REA CUSTOMER INQUIRY 09/12/02 13.03.07
MS ACTION SUCCESSFUL
PROD> CDA BRANCH 00114 COST CENTER 0000114
SUBPRDCT MT FIXED RATE
SUBOWNER 01 REGULAR
BANK
40
ACCT> """"--"'00.
CUSTOMER NUMBER 2001000637
NAME WENGER JOAljNE () I
/VIo.rCW.fei C.L0K.-N".sv--.
NAME JOANRt WENGER
& 703 16TH ST
ADDR NEW CUMBERLAND
PA 17070-1515
RELATIONSHIP
TIN 076-22-2373
WTHLD CD PV MISSING/INVAL CERT
DATE WTHLD CERT 08/28/2002
BIRTH DATE
LAST MAINT DATE
REA PLAN
PACKAGE CD
09/05/2002
SUB
MT
MT
C, -,;2.3 -9.3
.'~ A O~UN1-T, '. RST ISS/RENEW MATURES PKG
~ 06/23/1998 06/23/2003
2.""-~~ 04/25/2000 04/25/2005 HD
'-I -;)i:}-7S-
TOTAL
ADDED 05/12/1999
REMOVED 09/05/2002
COUNTRY
SEL
APY
5.25
5.66
CURRENT BALANCE
3,000.00
5,000.00
STAT
99
99
2
8,000.00
PF: I-HELP 2-MSGS 3-PLVL 4-RRS 6-CIF 7-S8 8-SF 9-CI34 10-ClI0 ll-Clll 12-CI50
Date: 9/12/2002 Time: 1:06:30 PM
Page: 1 Document Name: untitled
CI15 2 IDS CDA/REA CUSTOMER INQUIRY 09/12/02 12.59.12
MS ACTION SUCCESSFUL
ACCT> 2~~~_ PROD> CDA BRANCH 00114 COST CENTER 0000114
CUSTOMER NUMBER 2001000636 SUBPRDCT MT FIXED RATE
NAME GAINOR SANDP,A C (l." A 1 . ("' I SUBOWNER 01 REGULAR
Mc!.x~O..re 1 C - Lei/<-lVI -'1<\
NAME SANDY""GAINOR RELATIONSHIP SIB
& JOANNE WENGER TIN 194-44-9610
ADDR 1434 GREEN ST WTHLD CD PC CERTIFIED TIN
HARRISBURG PA 17102-2644 DATE WTHLD CERT 08/28/2002
BIRTH DATE 07/07/1951
LAST MAl NT DATE 09/05/2002
REA PLAN
PACKAGE CD
BANK
40
SEL
SUB ACCOUNT
MT _lll\'l4l.8202
MT~8248
(p . ~ 3 -9 3
RST ISS/RENEW MATURES PKG
06/23/1998 06/23/2003
04/25/2000 04/25/2005 HD
L{ .;)5 -Cf~
TOTAL
ADDED 05/12/1999
REMOVED 09/05/2002
COUNTRY
APY
5.25
5.66
CURRENT
BALANCE
0.00
0.00
STAT
07
07
2
0.00
PF: I-HELP 2-MSGS 3-PLVL 4-RRS 6-CIF 7-SB 8-SF 9-CI34 10-CI10 11-CI11 12-CI50
Date: 9/12/2002 Time: 1:05:26 PM
Page: 1 Document Name: untitled
Cll5 2 IDS
BANK 40
ACCT> ''''~~4
CUSTOMER NUMBER 2001008173
NAME CORNISH MARGARET E
NAME
&
ADDR
MARGARET E CORNISH
824 LISBURN RD APT
CAMP HILL
DECD
416
PA 17011-7100
COUNTRY
Lj-I).-95
ISS/RENEW
04/12/2001
02/28/2002
S-,;)9-'1r
SEL
SUB ACCOUNT
MT,.tJ1f.il'li};iJ"a~7m 4
NP ~_~l'~'o'll>I!"',.,
RST
TOTAL
CDA/REA CUSTOMER INQUIRY 09/12/02 13.03.46
MS ACTION SUCCESSFUL
PROD> CDA BRANCH 00114 COST CENTER 0000114
SUBPRDCT NP READY ACCESS CD
SUBOWNER 01 REGULAR
RELATIONSHIP
TIN
WTHLD CD PI INVALID
DATE WTHLD CERT
BIRTH DATE
LAST MAl NT DATE
REA PLAN
PACKAGE CD
076-22-2373
TIN/DECED
08/27/2002
11/05/1927
09/05/2002
ADDED 05/12/1999
REMOVED 09/05/2002
MATURES PKG
04/12/2003 HD
02/29/2004 HD
CURRENT BALANCE
0.00
25,000.00
STAT
08-
99
APY
2.96
2.00
PF: I-HELP 2-MSGS 3-PLVL 4-RRS 6-CIF 7-SB 8-SF 9-CI34 10-CI10 11-Cl11 12-CI50
2
25,000.00
Date: 9/12/2002 Time: 1:07:09 PM
QIoSl;1f) '1)/3)01
f~N.
Reference ID: 418559
First Union/Wachovia
Attn; Balance Confirmation Services
POBox 40028
Roanoke VA 24022-7313
September II, 2002
SAMUEL L ANDES, ATTORNEY
525 NORm TWELFTH STREET
POBOX 168
LEMOYNE, PA 17043
SUBJECT: Verification I Confirmation of Account and Balance Information provided for:
Customer: MARGARET E CORNISH (SSN# 076-22-2373)
Date of Death: July 12, 2002
DeDosit Account Information
Account
Type
CERTIFICATE OF DEPOSIT
Account
Number
Date of Death
Balance
Average
Balance'"
Date
Opened
Maturity Interest Accrued YTD Date
Date Rate Interest Interest Paid Closed
247412043558826
$10,000.00
4/811983 9/23/2002
$11.13
$117.60
LEGAL TITLE, MARGARET E. CORNISH
CERTIFICATE OF DEPOSIT 247412043559461
LEGAL TITLE, MARGARET E. CORNISH
$10,000.00
1/4/1984 612912002
$7.19
$84.62
CERTIFICA TE OF DEPOSIT 247412050824442
LEGAL TITLE, MARGARET E. CORNISH
$10,000.00
8/2411999 6/24/2003
$21.48
$186.27
CERTIFICATE OF DEPOSIT 247412050843729
LEGAL TITLE, MARGARET E. CORNISH
$65,011.63
8/3\/1999 6/30/2003
$95.98
$1,165.45
CHECKING 1014214321722
LEGAL TITLE MARGARET E. CORNISH
$1.00
5129/\ 998
NA
IRA
257020093556438
$11,685.67
7/8/1985
$21.17
$267.46
LEGAL TITLE MARGARET E. CORNISH
For Beneficiary Claim Form information, please call 1(800)669-2136.
'" Due to system limitations, we can only provide a twelve month average balance on depository accounts.
001032
f~N.
Reference ID: 418559
... Date of death balance does not include accrued interest.
'" If date of death Qccurrs on a weekend or a holiday. date of death balance does not include any transactions that were
made during that time period.
\)., lQ)..(u.)(jV1QGQ.o
'h{1~a Sorrells
Servicenter Associate
September 11, 2002
(540)563-7323
Phone Number
abs; at
001032
SUSQUEHANNA
~ ~ VALLEY
FEDERAL CREDIT UNION
September 13, 2002
Samuel L. Andes
Attorney at Law
525 N. Twelfth Street
PO Box 168
Lemoyne, PA 17043
Re: Margaret E. Cornish, deceased
SSN: 076.22.2373
Dear Mr. Andes:
The above referenced decedent had a share savings account and eight (8)
certificates with our institution. Details are given below. All the accounts were
titled in her name alone. All the accounts, including certificates, may be closed at
any time without penalty.
Accou nt Accou nt Date of Death Date of Death Total Date
Number Type Balance Accrued Interest Opened
1094.00 Share Savings $1,179.30 $ .48 $1,179.78 12/22/77
51.4224 C.:rtificate 3,500.00 .84 3,500.84 07/08/95
51.4239 Certificate 1,000.00 .72 1,000.72 07/20/95
51.9465 Certificate 1,000.00 .72 1,000.72 07/08/95
53.3962 Certificate 11,500.00 22.08 11 ,522.08 03/10/01
53-4050 Certificate 21,286.35 36.18 21.322.53 04/06/01
53-4238 Certificate 17,000.00 24.65 17,024.65 07/18/98
53-4399 Certificate 10,000.00 13.71 10,013.71 08/19/98
53-4382 Certificate 30,000.00 33.53 30,033.53 04/17/94
If we can be of any further assistance, feel free to ask.
Sincer~
(d~~
&-
Larry L. Stoner
President/CEO
i->Q
~
3850 HARTZOALE DRIVE. CAMP HILL, PA 17011-7809
LOCAL: (717) 737-4152 TOLL FREE: (800) 948-1454 FAX: (717) 737-0589
~
REV.l!ooEX.(I.Il1'l
'*'
SCHEDULE F
JOINTL V-OWNED PROPERTY
COMMONWEALn1 OF PENNSYLVANIA
INHERITANCE TAX RETURN
R~SIOENT DECEDENT
ESTATE OF
FILE NUMBER
21-02-0743
Cornish. Margaret E
If an asset was made joint within one year of the decedent's date of death, ft must be reported on Schedule G.
SURVIVING JOiNt TENANTiS) NAME
ADDRESS
RELATIONSHIP TO DE.CEDENl
A.
Sandra Gainor
1434 Green Slreel, Harrisburg, PA 17102
Daughter
B. Joanne Wenger
7717 Suitt Drive, Pasadena, MD 21122
Daughter
c.
JOiNTlY.OWNED PROPERTY:
LETTER DATE OESCR1PTlCNOf PROPERTY %OF DATE OF DEATH
ITEM FOflJOlNT MADE jl'lGlude name of finafICia instilUlion end bank a:counl number or simiia' identifying number, AlIach DATE OF DEATH DECO'S VALlJEOF
NUMBER TENANT JrnNT deellforjoill!ly.heldrealestale. VALUE OF ASSET INTEREST DECEDENTS INTEREST
1 A. 5/99 Certificate of Deposit No. 21001028249 with PNC $4,055.03 50% $2,027.51
Bank, N.A.
2. B. 5/99 Certificate of Deposit No. 21001028203 with PNC $3, 008.85 50% $1,504.42
Bank, N.A.
3. B. Certificate of Deposit No. 21001028247 with PNC $2,507.20
5/99 Bank, N.A. $5,014.39 50%
A&B Certificate of Deposit No. 21001028202 with PNC $3,008.85 33% $1,002.95
4. 5/99 Bank N.A.
5. A&B Certificate of Deposit No. 21001028248 with PNC $5,014.39 33% $1,671.46
5/99 Bank N.A.
TOTAL (Also enter on iine 6, Recap~ulation) $ 8,713.54
(If more space is needed, insert additIonal sheets of the same size)
PNC Danlt, N4
4242 Caj-lisle Pike
Camp I"Iill, PA 17011
Estate of Margaret E Cornish (Deceased)
SS# 076-22-2373
DOD 07-12-2002
PNCJIr}\NK
~
ACCOUNT NUMBER "DATE OF DEATH BALANCE of- ACCRUED INTEREST
'CDS #21001028202
CDS #21001028248
- CDS #21001028203.
CDS #21001028247
- CDS #21001028249
- C.IlS '1t!fjCl"DIJ'i'D83
t -- DD.~. #5140013287
elM) d< ; ~
$3,000.00
$5,000.00
$3,000.00
$5,000.00
$4,043.39
$~.), 000. ,'e
$~4,583.06
+
+
+
+
+
....
$8.85
$14.39
$8.85
$14.39
$11.64
eJl.q~
$1.91
U AJ /7
7 - UI - I.{)
+
Page: 1 Document Name: untitled
Cll5 2 IDS
CDA/REA CUSTOMER INQUIRY 09/12/02 13.02.30
MS ACTION SUCCESSFUL
PROD> CDA BRANCH 00114 COST CENTER 0000114
SUBPRDCT MT FIXED RATE
SUBOWNER 01 REGULAR
40
ACCT> ~~~~~,41lJ.
COSTOMER NOMBER 2001000638
NAME GAINOR SANgRA f) I
1W'v-tlftju(Q r E, L oeN is,,,
NAME ~AND?GAINOR
& 1434 GREEN ST
ADDR HARRISBURG
BANK
PA 17102-2644
RELATIONSHIP
TIN 194-44-9610
WTHLD CD PC CERTIFIED TIN
DATE WTHLD CERT 08/28/2002
BIRT~ DATE 07/07/1951
LAST MAINT DATE 09/05/2002
REA PLAN
PACKAGE CD
ADDED 05/12/1999
REMOVED 09/05/2002
COUNTRY
SEL SUB ACCOUNT RST
MT!"~r~i!illiil~&i!il'!i\.
ISS/RENEW MATURES PKG
04/25/2000 04/25/2005 HD
LJ -J~ -9S"
APY
5.66
CURRENT BALANCE
0.00
STAT
07
TOTAL
1
0.00
PF: I-HELP 2-MSGS 3-PLVL 4-RRS 6-CIF 7-SB B-SF 9-CI34 10-CI10 11-Cl11 12-CI50
Date: 9/12/2002 Time: 1:05:53 PM
Page: 1 Document Name: untitled
___.' _____o.'___._.____ _ _..____ _ .____.___._______ _ __._______~._......_._____..... ________..___...____ ._._..._____ .___,_
Cll5 2 IDS
CDA/REA CUSTOMER INQUIRY 09/12/02 13.03.07
MS ACTION SUCCESSFUL
PROD> CDA BRANCH 00114 COST CENTER 0000114
SUBPRDCT MT FIXED RATE
SUBOWNER 01 REGULAR
BANK
40
ACCT> ~:~:t!ll'~81f{Y~,
CUSTOMER NUMBER 2001000637
NAME WENGER JOA~NE C l
/V\QrCUlle"t C;. 01'-100\5."""\
NAME JOAN&E WENGER
& 703 16TH ST
ADDR NEW CUMBERLAND
PA 17070-1515
RELATIONSHIP
TIN 076-22-2373
WTHLD CD PV MISSING/INVAL CERT
DATE WTHLD CERT 08/28/2002
BIRTH DATE
LAST MAINT DATE
REA PLAN
PACKAGE CD
09/05/2002
SEL
SUB
MT
MT
o ..;2.3 -<] .3
Jl,~C;;,QUl-lT, RST ISS/RENEW MATURES PKG
2,iJllj~I21'~d''3'" 06/23/1998 06/23/2003
2~@~{~1il~$li~ 04/25/2000 04/25/2005 HD
4 -~-'1'S-
TOTAL
ADDED 05/12/1999
REMOVED 09/05/2002
COUNTRY
APY
5.25
5.66
CURRENT BALANCE
3,000.00
5,000.00
STAT
99
99
2
8,000.00
PF: I-HELP 2-MSGS 3-PLVL 4-RRS 6-CIF 7-SB 8-SF 9-CI34 10-CIIO ll-CIll 12-CI50
Date: 9/12/2002 Time: 1:06:30 PM
Page: 1 Document Name: untitled
CI15 2 IDS CDA/REA CUSTOMER INQUIRY 09/12/02 12.59.12
MS ACTION SUCCESSFUL
ACCT> 2illO~~Q2.~ PROD> CDA BRANCH 00114 COST CENTER 0000114
CUSTOMER NUMBER 2001000636 SUBPRDCT MT FIXED RATE
NAME GAINOR SANOfjA c. C (/ IV'S:' SUBOWNER 01 REGULAR
ll\/\(l-t- 90.( ej ~ - ()f--I I lA.
NAME SANDY GAINOR
& JOANNE WENGER
ADDR 1434 GREEN ST
HARRISBURG
BANK
40
PA 17102-2644
RELATIONSHIP SIB
TIN 194-44-9610
WTHLD CD PC CERTIFIED TIN
DATE WTHLD CERT 08/28/2002
BIRTH DATE 07/07/1951
LAST MAl NT DATE 09/05/2002
REA PLAN
PACKAGE CD
ADDED 05/12/1999
REMOVED 09/05/2002
COUNTRY
SEL
SUB ACCOUNT
MT2iL\Qi6J4<G28202
MT ~"i!'~""02824 8
RST
6 .). 3 -9 3
ISS/RENEW MATURES PKG
06/23/1998 06/23/2003
04/25/2000 04/25/2005 HD
Lj -J.') -CY.~
TOTAL
APY
5.25
5.66
CURRENT
BALANCE
0.00
0.00
STAT
07
07
2
0.00
PF: I-HELP 2-MSGS 3-PLVL 4-RRS 6-CIF 7-SB 8-SF 9-CI34 10-CII0 l1-CI11 12-CI50
Date: 9/12/2002 Time: 1:05:26 PM
Page: 1 Document Name: untitled
_.._-~-----_.._-------_.- -. --~-_._-_.__.._.._------~-_._----~-----.._---.._-"------.--.---- ._---------,
ACCT >'~~lihQ!l'Q.liiQ,~,~i.
CUSTOMER NUMBER 2001008173
NAME CORNISH MARGARET E
CI15 2 IDS CDA/REA CUSTOMER INQUIRY 09/12/02 13.03.46
MS ACTION SUCCESSFUL
PROD> CDA BRANCH 00114 COST CENTER 0000114
SUBPRDCT NP READY ACCESS CD
SUBOWNER 01 REGULAR
BANK
40
NAME
&
ADDR
MARGARET E CORNISH
B24 LISBURN RD APT
CAMP HILL
DECO
416
PA 17011-7100
COUNTRY
Lj-I).--95
ISS/RENEW
04/12/2001
02/28/2002
S-,;J-q-'j&'
SEL
RST
SUB ACCOUNT
MT ~&li!iIiUIQ!~4
NP 3.w;i!~il11;3,..,
TOTAL
RELATIONSHIP
TIN
WTHLD CD PI INVALID
DATE WTHLD CERT
BIRTH DATE
LAST MAINT DATE
REA PLAN
PACKAGE CD
076-22-2373
TIN/DECED
OB/27/2002
11/05/1927
09/05/2002
ADDED 05/12/1999
REMOVED 09/05/2002
MATURES PKG
04/12/2003 HD
02/29/2004 HD
CURRENT BALANCE
0.00
25,000.00
STAT
08-
99
APY
2.96
2.00
PF: I-HELP 2-MSGS 3-PLVL 4-RRS 6-CIF 7-SB B-SF 9-CI34 10-CIIO Il-CIII 12-CI50
2
25,000.00
Date: 9/12/2002 Time: 1:07:09 PM
- . _________.____"____._____ ___-. .___ ._____________.._______.__. "____.___. __0_'
c.l6sblD '1/1))0/
",.,,"'.,,"'.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESlCENT OCCEOENT
ESTATE OF
Cornish, Margaret E.
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON.PROBATE PROPERTY
FILE NUMBER
21-02-0743
Thts schedule must oe completed and filed if the Bnswerm any of Ql.lesnons 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY %OF
\1'EM IW"J..loO'i. ill<:lWJ,E(If tilt u~'I<mre:"". \\I'i,\ll.?"i.~llC?lQit"lODfCfnfm ....'4tli1E tlA1ECF1RlNSl'ER DATE OF DEATH DECO'S EXCLUSI~~ TAXABLE VALUE
AnI<CHACOPYo;T};EDl'EOFOR~EAl.ES1:,1€.
NUMBER VALUE OF ASSET INTEREST I'FAFPlICAllla
1, Individual Retirement Account No, 257020093556438 with $11.706,84 100% None $11.706,B4
First UnionlWachovia Bank (see statement attached),
2, Cash 9ift to Donald B, Cornish. Jr, (decedent's stepson) $10,000,00 100% None
made on 12 April 2002 $10,000,00
3, Cash gift to Joanne Wenger (decedent's daughter) made $10,000,00 100% None $10.000,00
on 12 April 2002
4, Cash gift to Sandra Gainer (decedent's daughter) made on $10.000,00 100% None $10.000,00
15 April 2002
TOTAL (Also enler on line 7, Recapitulation) $41.706,84
(If more space is needed, insert additional sheets of the same size)
---,--..- -,~~~~------_._----- ._-~
.. ~:a. /
'.
";nq 'OJUloH IUJOJun.il ;UOWOJlflJ8d
-eMlq'a pe\IB~PU\ MlPU'B\P.liYLll
941 4SlWnj pUll 8:l!1\.l9S 8lfi J9pUBJ 01 8ElJ6e 8M
(S)Jes1l'4:l,JndIOSJnl'eu6IS
.
apo::!drz
6111'IS pUB Nl::!
SS&JPP\fl9ElJIS
spa::! d!Z
9.elspUllNIO
(S)J8S94:l,Jnd JO aJntllu6!S
SS&JPP't'19&J1S
sPOOdlZ
~!O
.0N .S'S
illelS
9SeJPP'tI98JIS
(s)JeSBI(.l.Jnd 10 sJmllu6!s
m.
.sl:ln
.,.
.pa6perJ.\olJlj::re sll:JB.qUO:l SftIl lO.<doo tr JO ldte:Jill:llU8~ed l'llj SlfIlW 0\ elrlq!lluo:J In"'" Ll:le8 tpflW MOll SII^lB$weLlI
owe pElaJ6tr lMaLl 1118SBlj:lJOO 841 jO 'lOW JO f1UO IOU 10 J1I4184'"'- JO sselpsetleJ SISIll'8 1461' SIlU. .SJ9Sl'1(.llnd JIl4l0 ,(Ull ISUJ8511 WI"P ,(ua OIllOS8J InClt4l!'"'-
JS84:un(l8\.11 jO alOW JO euo.{ua WOl!lUflOWlI 1ll!\U1l eo.n \:lII\\'XI 0\ 114611- 94\ ftl.\ WIOH \8Iaun::l 841 SUI!llUlllJ9W.t.ed nnJ 8l\Wl ,/;jfal&1l9S pill!' J.nUlol Ol8S!WOld sN!
.u spuej5Jepun Jlls81.\::und lp'II3 .JOJ 8J8I./llUIlw.l:lld IIr1l9)jBW 01 IlSlWOJd 4eJIlMS PUll ,(pulOf PUl! 'llWlI$ aNJJdde pull 109:1011 'lI^Oqa 941 peaJ llU!^et! 'eM 10 'I
.sa61114::> relOl ~exa 941 aU!WJ9l9P OlluawJ;ed 6U!lapuas BlOleq e::>!UO lnO 41]M ~lnsuO:J
'eElld '~uewe~ms e lQU S[ S!'." '?t"d .lqap S\4\!O UO!}:)ellQ::> a\.U- U! P&JJn:JUll! UO!PQllOO}O S),SOO JatnO pUB S+SOO pno:J 'seal s,I.aUJoue
:reuOlWaJ Aed o~ s8aJ6e (s)Jes~::J,md ' aA!1::J9ue pa61el.l:l aq
A lN31"'lAVd 3.1V1 a3.L.....drQllN't'Nn lol wnuue lad % 10 96Je4::J..... .liIlep anp}o UO!~'el!dxa uodn .u.J3nON113a aN.....
"Ia .lS\r'd sawo::>eq 'SlUBM. lie Ul'pu'S Un. u! anp 'N01~VSNVI:I.l HS'v'::) 'e S! S!l.U. :SWt:l3l
.asIPuBlI:Uaw pUB 5a:JIAJItS JO UOtpillilS JO/pue qUBWa6uIW8 leJwRI
uOlssn:JslP 8'0 6u!UUI6aq 8l1J uodn JS!18Z)lJd IBJauaE) e Uonual8J 10' pBJliIUOJU&AI6 a1li1M eMII (t) "SJatJlB1UO:J Il'lJnq JaplO pUB
illse, .0 6uJH.O\.Is 81.11 aIOJeq lSl1 &:)\.Id .11lU181UOO I'elJnS Ja}l\O U'8' pU8lSn liI:JJ.ld ~a)!sll::J " UMOlIS ilIJaM 8M/! (c::) .pesBe:Jep paweu
,oqe alii 10 6UIWIBqW8 8ZlJ04V1B ( ) JOu P!p ( ) P!P "MIl (I.) :6UIMOII01 BtU 01 JSauB JiqillJetI (S)JasIl4:JJnd pau61SJapun 8lU
:3AOa.....
USI1 S~3ll AN.....;;IO 3S'v'H::;ll:lnd 3Hl E)NIl13dr-lOQ SlN3V\I3!:1ln03!:1l::13H.L0 I:JO Al::lOl.....W3l::l:l 'AI:J313r,13:J 'l\f931
$ 30NYn,S
)$
1$
)$
l~(al(vlIOllO!.
$
(^-!peds) JalUO
) alea IluewAed
I:I.L 0 SNI 0 eoueMolI...../luaw~snfpvpe9uasd
:SS31
$ (oll""'.l
$
$
I)~(vll..o!.
:SW3.L1113H.lO (0)
~ $ (a)I'IOW' ."-
_ ~('... \tt1(r~\~.1 ....(JrV t.'cJ.}-'!'-'O. lA.~ J J~~~ l..-l'OJ'I'C'- J
~ _ ,l'l, ./:,)~\'"'_
_ 01::;-'./ $.'. ','.. \,..;,.:<i; (,.J-(.J.--"...'''-~01 y; ~-j'5l" 1
I /-./ -?z
$ ..... .'V.J" \..)G' -'<.'IJ'-' '1 -f'':>-P'f9 '" JO "
$ ....... V"P""''''"''f? '1 "I 'O">PC.J ! #
$ . ':to/' +WJ..tiyt>fiYM. ;ii, if',if)rl .-ry[i(0 SlaMO[.,j
$ .....".......".. '. . .,. . . :. . . . . , . .'. . . . , . ,'. . . eu!snow!1
$ ....,. ,. ....,...........,.... ..... ..... uO!1elJodsueJ.L
t ........................... luawd!nb3AlalawaO'i~uel
$ .. ,..,., ...... ...... .."........ ... ... .,. JaSSaJp1!tlH
$ ..' ."'X).O";S'.:":";' ;;:;..~.;~'\\ .r,;";;.;:.'.' SEl!do:JP811lJ1e:J
...-' .:... Uo' {:.J/..;,_.:;..-
$ :.......'.........'........'...'..'.'.... sa:J!loNLAeea
$ .........".......,..,. .'. . . . . . . . . . , . . . .. ,. euoL/deI8.L
~ .$;:' ~J'':. $ pl'WO" (vi 1"01 :SI\I3!.130N\I^O'I' HS\lO (e)
. ,-......._~$
....t>a.~
,-
\1.~J.~.v.,,, .\ ~
'.:.....v,.., ,./t'~~........ U!.J..-~\., '\
-....,j r~)
.-->";/,~
-COI
-~17
--
-
-
-'"' vrY'
(dIIlSilO!llIlal::le^~l
L/Je8a 10 9;eo
:lO!AJes flu!fiuelJe uosJad JO
6<
S! pas'ee:>9a .
(8WUNJ.Nll:ld8S\lllldl
..,;,~;,\..,)U "',
../
pasee::>ep lO eweu IIn~
-96'\f
i 0;7 '"'
~---j i
Z! t1
Y51".\.'c:..\\ J~4.: \
.'..
. . l
~.
.ON
8? lie $
$
$
$
$
$
$
$
$
$
.~
-
- ~~ f,)" C.
-
- ..sPIL'l $
,.....,............".......".....,. (p91::J9ras S'lf) l'lfJl:lnS 3.1.Vla3~V'I/
".......,..,......,....".."..,...'.. (pa1:l9\9SsV)NO\.l.V\'ll3~-:)1-:)3'd\G
, . . . . . . , . . ,. 3~OH 1\fl:l3Nn;;l1:l3HlONV YIIDl:l;;l SNIWl3l:/:l0 9NIA/3031:1
...,.......,..." 3~OH"W\:;\3N(\;;!\:;\3HlON\r'OlSNI'd~B'tI~O~IOWM'tlO~
(ep!Surl X!J!=lrua
(9PJS1T'lo)x>>~o
181eddy BU!18aM
~9>lS80 IBlueH
W.J( l~i' /J U 7-Z1 H (;9)!seO U91n J8410) epeld~al;;l
:3SION'v'HOt:l3Wl:l3HlO
(~) 113'101
"'dB~5
o
NWUO
",..
\,,~f''i
....
I'i
-'
$
(papeles SV) 1::/3NI'V lNO:J lVIl::lna l:I3.1.nO
$
./"
~
.~
13~SVO
1 ~ ..... \:.; .:__ h ':;: -- --z"Z ::'J;. :;n....i7,.rT "T"D I'~"CF/ / m
$.~[ff'; ..~.).J .rv....:. 'J' SpJe~leAeJd ISJaprO:l19!JOWeW
""1~ ~..~''', (1J'.;I \..' \j.
$ .".:;1; IV ; . oj. tr<..,. . . .,r. . . . . \V . . .' lelsl6eu Sl01lSIA
. I, _,,\ \ . 0 ..
$ .:..:..:..... .,':'" 'Pt'. ',."'16 ti1\ . : '. sple::;l ~u9tu6palMoU)IOV
,......,~)\,.. ,
'f" -' \ ./ !'; :3SIONVH:J1::l3W sn03NVl13::;lSIVi
/'
--
$ ........".......,.,.,.... .......... 'Je:J9::J!AJ8S
$ ........,........ ..... .'.....' 113':JJeMOt::l
$ ........,...................,..... . uepesrel:J9un=,
$ ........................... (esJeeHllf.l'eoQ le)(S'e:J
:LN3V<ldln033AllOWOl.OV
(pe110dSUellsel!Vo{ - )
$ .......... 3r-lOH 1'v'l::I3Nn;;l O.L SNIVVi31::l :10 !:I3::1SNYl::I.L
$
$
$
$
$
$
........,
./"'
,./'
/l
--
................,.............. .e:JINSS 8p!S6^llJ9
....."...... (,{jjI:JllJJ'4lOU8'lV~) 9O!^"eg re!1OW9Vl1
. . . . . . . . , . . . (4\Wllll-*ll'1'1\l \11 i>>\OI'lPUOO ) 6ulMel^ , UOl~~!S!^
. . . . . . , . . . . . (.., JiIlllOUlll1! P'\OI'IIlUOO ) AUOWeJ9::;l j8Jeun;;l
.,,';
./'
././7
.........
-
:J.N3~dln03 QNV :B'o'~5 .:I03Sn
$ ...... ..~' ~.:)J p-' , i..: :;.., / t /i ~~~';"';.-"...l(..;oj
$ ..,............ {8WtlH~::llVp8l:II'IpUQ:J)90!hleSleI.lOW9r;
$ ........,..,. (IWDH"".un::llllpllOnpUO:J)6u!MelA/uo!1B1ISIA
!Ii ............. t8WDHIBJIlUn.:llllplll:ll1PUO:J) I.uowElJe:J IBleun;;l
:.LN3Wdln03' ""V!.S 'S31.lJ110V" "0 3sn
$ ................. AOOO3HUONOI.l\fl:f1ld3UdU3H.lO
,
~-lLiZ
~gg
;:q~~
~~~
~.....~
mm'
, . ~
t!{3:-n
Zme
~~o
> ~
~ >
z .
o ~
" ~
m ~
,..,.......
:ElNIW1VaW3 UO" NOS\'3U
"/tIO/flQAqAI
u/s/dxeltlA' 8At 'Bu/UJ/fJqWfl.lDJ pa6.Jf1II:J aMB "lflt.lnqfllll/pBUlUJI
JO uonrnu8.l:J I:>a1JP If n 11MB ~UflUJe6ull.J.R ~_ noA
llaAO.lddlf IOU PIP noA' 6u/UJ/tlQUUJ.IOJ.fad", BIIlIII ,ou op noA
"6UfWlfJqlUe.lOJ AIId ", MINI A'.w noA '6U/IM/A /flINt fRJ8UfIJ II
"lPn$ 6U1WJlHlWa iU,nW Aew pnn fIU'UIJI" p8l>>IfJ$ noA B
$ .. .... .... ........... ....... ...... .....ElNIl'lWSl'l3
'$ ..... :l:J'tJ.lS "i 'dOl:l3l:.ilO lW3Nn.:l ::10 S3:J1^\:I35 ::IISV8
:301^1I3S IIno (\I)
'JoplfllP laleoJr\j 64\ /I:J, pl,J13 ~ \'BJ9U1'4 8\,1\ JCI5Ul&ra1m '$uos.led JO \JOSJsd SIJl Mt pau6rs eq 01l:J811tJClO
S]41 seljnbsJ SJOlO6JIO l1UeUn:llo pleos SIBtS 'BIUBAf,(suued e41 jO SUOll'Bln66!:l PUB selnH ell. 10 VOz:.t~ uOlloes
(.^,018CI 6UlllJM UI SUOS"J atn uleldxB 11IM alA 'SWIIlI Jiuaasn 01 JiJoPlW",:J JO ~ "
Jiq 10 MBI 1.1\ p8JlnbaJ ale aM 1-1 .pa.I\nbaJ eJ1I ,~ .ao pe~ noA 1-8\.11 sw8l\ esoq} JO} AIUO 8Jl8 sa1SJlt\.I,O)
(a3103135 $3:>IAI:i35 aNY saOOD 1'tt:l3NI1:J.:I0 J.N3W31.'tJ.S)
l:>'tt:lJ.NO:::> 35'tH:>l::tnd 1Yt:l3Nn.:l
~,
,/
a:u;
REV.1Sn EX.. (\2-99),_
<" 'A 9
&i.~fX "
.~\~i~
COMMONWEALrH OF PENr~SYLVANiA
INHERIMNCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF ,
Cornish, Margaret E.
FILE NUMBER
21-02-0743
Debts of decedent must be reported on Schedule I.
Cily_____,..
Stale .'m_""_._ Zip
...._n_.
AMpUN
$3,351.00
-.
--,-
$5,000.00
$270.00
T
ITEM
2~~~_~_13m
A. FUNERAL EXPENSES:
DE.sg!!",TION
1.
Parthemore Funeral Home
1303 Bridge Street
New Cumberland, PA
B. ADMINISTRATIVE COSTS:
1 Personal Representative's CommisSions
Name of Personal Representatil/e{sl ~_?_~E
Social Se(;urity Number{sl/EIN Number of Personal Represenlalive(sl
StreelAddress
Yearl51 Commission Paio:
2. At\omey Fees Samuel L. Andes
3. Family E~empt\w, \\1 oeceoerds address is no\ the same as claimant's, attach explanation)
Claimant
N/A
SlreetAddress
City __~_____~~
. _ ,.Slale____..Zip
Relationship of Cla'lmanllo DacadF,lnt
4, Probate Fees Register of Wills
5. Accounlanl's Fees
6
Tax Return Preparer's Fees Larry Shoop, CPA
$200.00
$75.00
$87.35
$60.00
$90.00
7.
Cumberland Law Journal (advertising)
The Sentinel (advertising)
Frank Baker (stock-bond appraiser)
Scott Portzllne (moving and disposal expense)
TOTAL (Also enter on line 9, Recapitulalion) $ 9, 133.35
ill more space is needed. insert additional sheets of the same size)
REV-.1513 EX~ (9-00) i'
~*'
COMMONWEALTH OF PENNSYLVANIA
lNt.Il=RITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Cornish, Margaret E.
21-02-0743
FILE NUMBER
AMOUNT OR SHARE
OF ESTATE
RELATIONSHIP TO DECEDENT
__~.~~~_~~_ __ NAME AND ADDRESS OF PERSON(S) AECElVlNG PROPERTY Do Not UstTrustee{s)
J TAXABLE DISTRIBUTIONS \incluoo outright spousal dislribulions, and Iranslers under
Sec. 9116 (all1.2)]
1. Ara Guille, 909 Sunrise Ave., Bellmore, NY 11710 Stepgranddaughter
2.
Zachary Holmes, 510 Observer Highway, Apt. 4W,
Hoboken, NJ 07030
3.
William Richards, Jr., 3935 Heild Road NW, Palm Bay, FL
32907
4.
Sandra Gainor, 1434 Green Street, Harrisburg, PA 17102
5.
Joanne Wenger, 7717 Suitt Drive, Pasadena, MD 21122
6.
Donald B. Cornish, Jr., 103 Linden Drive, Camp Hill PA
17011
Stepgrandson
Grandson
Daughter
Daughter
Stepson
$2,000.00
$2,000.00
$2,000.00
$13,500.00 plus
one-quarter of
remainder
$13,500.00 plus
one-quarter of
remainder
$30,000.00 plus
one-half of remainder
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPHIME, ON REV-150\) COVER SHEET
n NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL OlSTRtBunONS UNDER SECTION 9113 FOR WHICH AN ELECTION 10 TAX 15 NOT BEING MADE
1.
N/A
B. CHAllITABLE AND GOVERNMENTAL DISTRIBUTIONS
t.
TOTAL OF PART n - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1S00 COVER SHEET $ 0.00
(If more space is needed, insert additional sheets 01 the same size)
In
.~
~J_
CERTIFICATION OF NOTICE UNDER RULE 5.6fa)
Name of Decedent: Margaret E. Cornish a/k/a Margaret West Cornish
Date of Death: 12 July 2002
Will No. Admin. No. 2002-00743
To the Register:
I certify that notice of beneficial interest required by Rule 5.6(a) of the
Orphans Court Rules was served on or mailed to the following beneficiaries of the
above-captioned estate on 30 August 2002.
Name Address
Donald B. Cornish, Jr. 103 Linden Drive, Camp Hill, PA 17011
Joanne Wenger 7717 Suitt Drive, Pasadena, MD 21122
Sandra Gainor 1434 Green Street, Harrisburg, PA 17102
Ara Guille 909 Sunrise Avenue, Bellmore, NY 1 1710
Zachary Holmes 510 Observer Highway, Apt. 4W, Hoboken, NJ 07030
William Richards, Jr. 3935 Heild Road NW, Palm Bay, FL 32907
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except:
None
Date: `~~3~` ~~
Sig ature
Name: Samuel L. Andes
Address: 525 N. 12th Street
Lemoyne, PA 17043
Telephone #717 761-5361
Counsel for Personal Representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
ANDES SAMUEL L ESQUIRE
525 N 12TH STREET
LEMOYNE, PA 17043
-------- fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: ssrv: o7s-22-2373
FILE NUMBER: 2102-0743
DECEDENT NAME: CORNISH MARGARET E
DATE OF PAYMENT: 1 1 /07/2002
POSTMARK DATE: 00/00/0000
couNTY: CUMBERLAND
DATE OF DEATH: 07/ 1 2/2002
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 ~ 512,291.34
TOTAL AMOUNT PAID:
REMARKS: SAMUEL L ANDES ESQUIRE
NO CHECK #
INITIALS: JA
SEAL
RECEIVED BY: MARY C. LEWIS
512,291.34
REGISTER OF WILLS
REV-1162 EX111-96)
N0. CD 001822
REGISTER OF WILLS
~/~-~~-mod
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
SAMUEL L ANDES
525 N 12TH ST
LEMOYNE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-1547 E% AFP (01-02)
DATE 12-23-2002
ESTATE OF CORNISH MARGARET E
DATE OF DEATH 07-12-2002
FILE NUMBER 21 02-0743
COUNTY CUMBERLAND
ACN 101
Amount Remitted
PA 17043
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~
----------------------------------------------------------------------------------------------------------------
REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF CORNISH MARGARET E FILE N0. 21 02-0743 ACN 101 DATE 12-23-2002
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule Dl
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
[1) .00
(2) .00
(3) .00
(4) .00
(51 231, 853.86
(61 8,713.54
(71 41,706.84
(8)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
282,274.24
APPROVED DEDUCTIONS AND EXEMPTIONS: 9,133.35
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
11. Total Deductions (11l 9.133.35
12. Net Value of Tax Return (121 273, 140 .89
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
t to Tax
t
S
bj
f E
t
t V
l (141 273,140.89
14. ec
e
u
s
a
a
ue o
Ne
NOTE: If an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
00
00
. 00
15. Amount of Line 14 at Spousal rate (15) • =
X
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 273,140.89 X 045. 12,291.34
17. Amount of Line 14 at Sibling rate (17) • 00 X 12 . 00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 .00
al Tax Due
P
inci
19 (191. 12,291.34
r
p
.
TLV !~l.rwTTl+~
•
DATE
NUMBER +
INTEREST/PEN PAID (-) AMOUNT PAID
11-07-2002 CD001822 .00 12,291.34
TOTAL TAX CREDIT 12,291.34
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
^ IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate far
life or far years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxe<_
at the lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S.
Section 9140).
PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side.
--Make check or money order payable to: REGISTER OF WILLS, AGENT
REFUND (CRI: A refund of a tax credit, which was not requested an the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office
of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour
answering service for forms ordering: 1-800-362-2050; services far taxpayers with special hearing and / or
speaking needs: 1-800-447-3020 (TT only).
OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (607 days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
ADMIN-
ISTRATIVE
CORRECTIONS: Factual errors discovered an this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (7177 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent' CREV-1501) for an explanation of administratively correctable errors.
DISCOUNT: If any tax due is paid within three (3l calendar months after the decedent's death, a five percent (5%) discount of
the tax paid is allowed.
PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has bean assessed as indicated on this notice.
INTEREST: Interest is charged beginning with first day of delinquency, or nine C9) months and one (1) day from the date of
death, to the data of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent an and after
January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are:
Veer Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor
1982 20% .000548 1992 9% .000247
1983 16% .000438 1993-1994 7% .000192
1984 11% .000301 1995-1998 9% .000247
1985 13% .000356 1999 7% .000192
1986 10% .000274 2000 8% .000219
1987 9% .000247 2001 9% .000247
1988-1991 11% .000301 2002 6% .000164
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen C15) days
beyond the date of the assessment. If payment is made after the interest computation data shown on the
Notice, additional interest must be calculated.
c~i
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Margaret E. Cornish
Date of Death: 12 July 2003
Will No.
To the Register:
Admin. No. 21-02-0743
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the esta! a is complete: yes no
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No. 1 is Yes, state the following:
A. Did the personal representative file a final account with the
Court? Yes No x
B. The separate Orphans' Court No. (if any) for the personal
representative's account is:
C. Did the personal representative state an account informally to the
parties in interest? Yes~C No
D. Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk of the Orphans' Court and may
be attached to this report.
Date: ~ I .~ ~ b3 ~~~~
I I
Sign ure
Name: Samuel L. Andes
Address: 525 N. 12th Street
Lemoyne, PA 17043
Telephone # 717 761-5361
Capacity:
.-~~ ~ Counsel for Personal
- Representative
_,~